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Medicine > Thyroid dz > Flashcards

Thyroid dz Flashcards

1
Q

when would you use thyroid scan and uptake?

A

hyperthyroidism

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2
Q

what is normal thyroid uptake at 4-6 hours?

A

5-15%

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3
Q

what is the normal thyroid uptake at 24 hours?

A

15-25%

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4
Q

what does the scan help you determine?

A

hetero or homogenous distribution

-determined by cold/hot areas of uptake on scan

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5
Q

what supplements can influence synthroid levels?

A

calcium and iron

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6
Q

what is a common side effect of synthroid?

A

CP

palpitations

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7
Q

what comorbidities can impact synthroid absorption?

A

malabsorption

GI conditions

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8
Q

what should you do when giving synthroid to an elderly person?

A

1/2 of a 25 mcg tablet twice a day
go slowly and make small dose changes
(risk of precipitating a cardiac event)

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9
Q

how often should you check TSH and free T4 levels?

A

every 6 weeks

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10
Q

what is armour thyroid?

A

pork thyroid extract

measured in grains

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11
Q

what is thyrotoxicosis?

A

hyperthyroidism

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12
Q

what is the dosing frequency of methimazole?

A

once daily

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13
Q

what is a significant side effect of antithyroid drugs?

A

agranulocytosis

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14
Q

which anti thyroid is the DOC during pregnancy?

A

PTU

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15
Q

which antithyroid drug inhibits conversion of T4-T3?

A

PTU (also has risk of hepatic failure)

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16
Q

which is the DOC during a thyroid storm?

A

PTU

17
Q

what drug might you also consider if sxs don’t resolve quickly?

A

beta-blocker
(one month taper is common)
-reduces some peripheral conversion of T4-T3

18
Q

what condition can worsen with RAI especially in smokers?

A

opthalmopathy

19
Q

what has to happen before giving RAI?

A

stop antithyroid drugs for 7 dys before RAI

20
Q

what is a typical presentation in the elderly of hyperthyroidism?

A

apathetic

AMS

21
Q

what are the risk factors for thyroid nodules?

A 
age
female > male
hx of head and neck irradiation
family hx of thyroid cancer
iodine deficiency
22
Q

what factors increase the risk of malignancy?

A 
pt 70
male > female
hx of radiation
family hx of thyroid cancer
environmental toxins
23
Q

when is a fine needle aspiration indicated?

A

palpable nodules and >10mm or with risk factors for malignancy

24
Q

which type of thyroid nodule is the most common and has the best cure rate?

A

papillary

25
Q

what type of thyroid nodule has the worst prognosis?

A

anaplastic (no differentiation)

26
Q

which type of thyroid tumor is associated with MEN (multiple endocrine neoplasias)

A

medullary carcinoma

27
Q

which alpha blockers are used during pheo surgery?

A

phenoxybenzamine

doxazosin

28
Q

which calcium channel blockers are used during pheo surgery and other HTN crisis?

A

nifedipine ER

nicardipine ER

29
Q

which beta blockers are used to manage tachycardia and arrhythmias during pheo surgery?

A

metoprolol

Medicine (146 decks)

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